MEDICARE: DR. FRANK R. EGAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	044609	NY
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN016152	GA

General Provider Information

NPI Number	:	1982729703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK R. EGAN D.D.S.

Provider Business Mailing Address
First Line	:	11090 SERENBE LN STE 300
Second Line	:
City	:	CHATT HILLS
State	:	GA
Zip	:	30268-2474
Country	:	US
Telephone Number	:	770-771-5855
Fax Number	:

Provider Business Practice Location Address
First Line	:	11090 SERENBE LN STE 300
Second Line	:
City	:	CHATT HILLS
State	:	GA
Zip	:	30268-2474
Country	:	US
Telephone Number	:	770-771-5855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	07/27/2023

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